Hepatomegaly is a medical condition characterized by abnormal enlargement and the presence of scattered signs of changes in the liver. It is not a standalone condition but rather considered one of the symptoms of several diverse medical conditions, ranging from viral liver infections to liver fibrosis. Liver specialists, in collaboration with other specialized physicians, investigate the causes of this type of symptom in adults, its overall impact on health, and the necessary treatment.

About the Disease:
In a normal state, the liver has a relatively smooth texture. On palpation, the lower edge of the liver can be identified on the right side below the rib cage, but it should not exceed more than 1-2 cm. Enlargement exceeding 12 cm on the mid-right line or easy palpation in the upper thigh area (in the solar plexus area) indicates pathological enlargement.

Classification of Hepatomegaly:

  • Mild: Slight changes occur in liver tissues and are only evident during instrumental examination.
  • Complete: Liver size increases by 10 cm.
  • Scattered: Liver size exceeds the normal limit by more than 10 cm.
    In most cases, experts classify the syndrome into several types based on the primary cause of disease progression. Hepatomegaly can result from endocrine diseases, poisoning, injury, circulatory disorders, etc. The location of pathological changes is also taken into account when making a diagnosis.

Symptoms of the Disease:
Symptoms of hepatomegaly are determined based on the underlying medical condition. In cases of mild hepatomegaly, symptoms may not appear for a long time, especially in young individuals. However, in complete hepatomegaly in adults, the following symptoms may occur:

  • Discomfort and pain under the ribs on the right side, which worsens with movement.
  • Unpleasant mouth odor.
  • Increased gas formation in the intestines.
  • Alternating constipation and diarrhea.
  • Nausea, especially after eating or consuming alcohol.
  • Itching of the skin.
  • Loss of appetite.
  • Blood rash on the body.
  • Sleep disturbances.
  • Emotional instability.
    In cases of hepatomegaly resulting from viral hepatitis, jaundice, discoloration of the mucous membranes, and general symptoms of body poisoning accompany it. In cases of liver fibrosis, the liver becomes palpable, frequent bleeding occurs, and nausea and pain in the upper abdomen become constant.
    When hepatomegaly is due to benign or malignant tumors, abdominal size may increase on the side of the tumor. The patient experiences pain, digestive disorders, and fluid accumulation in the abdominal cavity.
    In cases of liver poisoning, hepatomegaly is the main symptom, and in some cases, it is accompanied by irritating skin itching, nausea, jaundice, and eye discoloration.


Hepatomegaly can be a sign of many diseases. Often, hepatomegaly occurs due to vascular disorders, especially as a result of portal vein effects, thrombosis, venous congestion, etc.
Other causes of hepatomegaly include:

  • Acute inflammatory infections of the liver (hepatitis, viral infectious mononucleosis, non-specific cholangitis, etc.).
  • Formation of benign and malignant tumors in the liver or surrounding structures.
  • Amyloidosis.
  • Hemochromatosis.
  • Food poisoning.
  • Fatty liver disease.
  • Thalassemia.
  • Some cardiovascular and vascular disorders.
    The chances of hepatomegaly increase in individuals who:
  • Suffer from endocrine disorders.
  • Regularly consume alcoholic beverages, regardless of the type of alcohol.
  • Take various medications regularly.
  • Misuse medications by increasing the dosage or altering the dosing schedule.
  • Work in the chemical industry.
  • Are obese.
  • Have little physical activity.
    Mechanical liver damage, autoimmune conditions, and congenital abnormalities in the liver system can also lead to hepatomegaly.

In diagnosing hepatomegaly, initial steps for the physician include:

  • Patient history, medical history collection, and complaints.
  • Evaluation of skin condition, mucous membrane color, and sclera color.
  • Auscultation, percussion (finger tapping), palpation of the liver, and determination of its location and size.
    To determine the cause of hepatomegaly objectively, a set of laboratory and instrumental tests are assigned, including:
  • Ultrasonography of the liver and other organs in the abdominal cavity.
  • Liver biopsy in cases of suspected tumors.
  • Comprehensive blood analysis.
  • Biochemical blood analysis.
  • Polymerase chain reaction (PCR) testing for infections.
    If necessary, an extensive diagnosis may include CT scanning of abdominal organs, radiographic scanning using contrast agents, Doppler ultrasonography, and other diagnostic methods.
Treatment tactics are determined based on the underlying medical condition.
Medications used in treatment may include:
  • Hepatoprotective agents.
  • Antivirals.
  • Antibiotics.
  • Anticoagulants.
  • Hormones.
  • Cardiac medications.
    Detoxification procedures and restoring balance are implemented.
    Nutritional and lifestyle reforms play a significant role in treating hepatomegaly. Avoidance of alcohol, fatty foods, fried, spicy, preserved, and fast carbohydrates is necessary. The doctor may prescribe a range of essential minerals and vitamins to support the required mineral levels in the body.
    In cases of cancerous tumors in the liver, treatment is directed towards radiation, chemotherapy, or radiation therapy. In cases of limited damage, drainage is performed.
    If conservative treatment has no effect or if the medical condition causing hepatomegaly and other symptoms are in an advanced stage, surgical treatment is directed. In more complex cases, a decision may be made to remove the damaged part of the liver or perform a liver transplant.
  • Grigoriev P.Ya., Yakovenko A.V. Clinical Gastroenterology. Moscow: Med. Information Agency, 1998.
  • Sherlock S., J. Dooley. Liver and Biliary Diseases: Practical Guide. Translated from English / Ed. by Z.G. Aprosina, N.A. Mukhin. Moscow: GEOTAR-MED, 2002.